Geospatial and Transport Modeling in Stroke Service Planning - Volume II

Six years on from the first Volume of this Research Topic, the case for thoughtful, data-driven stroke service planning is stronger than ever. Endovascular thrombectomy has expanded into late time windows (up to 24 hours), into large ischaemic cores (SELECT2, RESCUE-Japan LIMIT, ANGEL-ASPECT), and into basilar artery occlusion (ATTENTION, BAOCHE). Tenecteplase is rapidly replacing alteplase as the thrombolytic of choice in many systems following AcT, TRACE-2, and ATTEST-2. Mobile Stroke Units have moved from proof of concept to demonstrated benefit on functional outcomes (BEST-MSU, B_PROUD), and the conversation has shifted from “should we?” to “where, how many, and for whom?”.These clinical advances place even greater pressure on the systems that deliver them. Pre-hospital triage decisions, hub-and-spoke configurations, transport routing, and workforce distribution all need to evolve in step — and the same data-driven thinking applies well beyond the hyperacute window, to rehabilitation access, long-term follow-up, and the geographic patterning of outcomes. Volume II of this Research Topic invites researchers, clinicians, and operational scientists to share the next generation of geospatial and transport modeling work that will shape the stroke services of the coming decade.We particularly welcome contributions on:- Modeling for extended-window and large-core thrombectomy eligibility, and how this changes optimal hub placement and transport boundaries.- Mobile Stroke Unit deployment, scaling, and cost-effectiveness, including airborne and rural configurations.- Pre-hospital large vessel occlusion (LVO) detection, including the integration of validated clinical scales, biomarkers, and emerging portable imaging.- Artificial intelligence and machine learning for triage decision support, automated imaging interpretation (CTP, CTA), and dynamic routing.- Telestroke and tele-thrombectomy networks, including the structural changes accelerated by the COVID-19 pandemic.- Drip-and-ship versus mothership revisited, with updated conditional probability models reflecting modern reperfusion outcomes and tenecteplase pharmacology.- Equity, access, and stroke care in rural, remote, and low- and middle-income settings, including indigenous and underserved populations.- Geospatial inequality in stroke outcomes, including small-area variation in mortality, disability, and quality of life, and the modeling approaches used to quantify and explain it.- Access to post-acute and rehabilitation services, including geospatial modeling of inpatient rehabilitation, early supported discharge, community therapy, and long-term follow-up across urban and rural catchments.- Workforce modeling, including the neurointerventionalist and stroke physician pipeline.- Climate and sustainability considerations in stroke transport, such as the environmental footprint of MSUs, helicopter EMS, and alternative routing.- Open-source tools, reproducible code, and shared data for geospatial analysis, simulation, and discrete-event modeling of stroke pathways.- Real-world implementation and registry-based evaluation of network changes, including before-and-after analyses of newly designated comprehensive stroke centres.Building on the foundations of Volume I, we continue to encourage authors to share source code and reproducible workflows alongside their manuscripts, so the community can build, adapt, and learn from one another. The vision remains the same: stimulate readers to design transport and service models that meet their local needs, while contributing to a global evidence base on how to deliver the right stroke therapy to the right patient at the right time — across the full pathway, from symptom onset to long-term recovery.Whether you work in metropolitan, regional, rural, or international low-resource settings, we invite you to contribute to this next chapter. Volume I reached over 106,000 readers and resulted in a widely downloaded ebook. With your work, Volume II can do the same and more.Volume I - https://www.frontiersin.org/research-topics/8362/geospatial-and-transport-modeling-in-stroke-service-planning/magazine Topic editors: Noreen Kamal, THANH G PHAN, Richard Beare Source: https://www.frontiersin.org/research-topics/80822/geospatial-and-transport-modeling-in-stroke-service-planning---volume-ii